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Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy.

Lasson, Åke LU ; Lundagårds, Jan; Lorén, Ingemar LU and Nilsson, Paul E (2002) In European Journal of Surgery 168(5). p.264-269
Abstract
OBJECTIVE: To present our results of non-surgical primary management of appendiceal abscesses using ultrasonic percutaneous drainage under local anaesthesia, and selective interval appendicectomy. DESIGN: Retrospective study. SETTING: University hospital, Sweden. SUBJECTS: 24 patients with appendiceal abscesses 3-12 cm in size. INTERVENTIONS: Primary ultrasonic percutaneous drainage under local anaesthesia, antibiotic treatment, and selective surgical treatment. MAIN OUTCOME MEASURES: Long-term follow-up. RESULTS: All patients had their abscesses drained successfully without complications. One patient continued to have fever, but eventually responded to conservative treatment and in one the bowel was perforated by the drain but again this... (More)
OBJECTIVE: To present our results of non-surgical primary management of appendiceal abscesses using ultrasonic percutaneous drainage under local anaesthesia, and selective interval appendicectomy. DESIGN: Retrospective study. SETTING: University hospital, Sweden. SUBJECTS: 24 patients with appendiceal abscesses 3-12 cm in size. INTERVENTIONS: Primary ultrasonic percutaneous drainage under local anaesthesia, antibiotic treatment, and selective surgical treatment. MAIN OUTCOME MEASURES: Long-term follow-up. RESULTS: All patients had their abscesses drained successfully without complications. One patient continued to have fever, but eventually responded to conservative treatment and in one the bowel was perforated by the drain but again this was treated conservatively. Four abscesses recurred. Seven patients underwent planned interval appendicectomy. Another three patients were also operated on-one for caecal adenocarcinoma, and two for persisting symptoms and enterocutaneous fistulas. CONCLUSIONS: Appendiceal abscesses can be effectively drained percutaneously using ultrasound-guided drainage under local anaesthesia, without complications. Recurrent appendicitis is common, and malignancy is a substantial risk in elderly patients. Modern laparoscopic appendicectomy and early postoperative discharge makes interval appendicectomy a valid treatment option after primary non-surgical management of appendiceal abscesses. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Surgery
volume
168
issue
5
pages
264 - 269
publisher
Taylor & Francis
external identifiers
  • pmid:12375607
  • wos:000177730300003
  • scopus:0036377971
ISSN
1102-4151
DOI
10.1002/ejs.44
language
English
LU publication?
yes
id
01fc0d6e-0b82-44be-8133-38824c3d58e9 (old id 110688)
date added to LUP
2007-07-25 10:38:37
date last changed
2017-08-06 04:23:48
@article{01fc0d6e-0b82-44be-8133-38824c3d58e9,
  abstract     = {OBJECTIVE: To present our results of non-surgical primary management of appendiceal abscesses using ultrasonic percutaneous drainage under local anaesthesia, and selective interval appendicectomy. DESIGN: Retrospective study. SETTING: University hospital, Sweden. SUBJECTS: 24 patients with appendiceal abscesses 3-12 cm in size. INTERVENTIONS: Primary ultrasonic percutaneous drainage under local anaesthesia, antibiotic treatment, and selective surgical treatment. MAIN OUTCOME MEASURES: Long-term follow-up. RESULTS: All patients had their abscesses drained successfully without complications. One patient continued to have fever, but eventually responded to conservative treatment and in one the bowel was perforated by the drain but again this was treated conservatively. Four abscesses recurred. Seven patients underwent planned interval appendicectomy. Another three patients were also operated on-one for caecal adenocarcinoma, and two for persisting symptoms and enterocutaneous fistulas. CONCLUSIONS: Appendiceal abscesses can be effectively drained percutaneously using ultrasound-guided drainage under local anaesthesia, without complications. Recurrent appendicitis is common, and malignancy is a substantial risk in elderly patients. Modern laparoscopic appendicectomy and early postoperative discharge makes interval appendicectomy a valid treatment option after primary non-surgical management of appendiceal abscesses.},
  author       = {Lasson, Åke and Lundagårds, Jan and Lorén, Ingemar and Nilsson, Paul E},
  issn         = {1102-4151},
  language     = {eng},
  number       = {5},
  pages        = {264--269},
  publisher    = {Taylor & Francis},
  series       = {European Journal of Surgery},
  title        = {Appendiceal abscesses: primary percutaneous drainage and selective interval appendicectomy.},
  url          = {http://dx.doi.org/10.1002/ejs.44},
  volume       = {168},
  year         = {2002},
}